No worries in front of the braces

When orthodontic treatment is really necessary and what parents should bear in mind.

Like pearls arranged in even rows – ideally the teeth should stand and fit harmoniously into the jaw. But in the mouths of our offspring it usually doesn’t look that perfect. According to statistics, more than 50 percent of children and adolescents in Germany are affected by tooth and jaw malpositions. About half are congenital, other problems are homemade.

Reason for the braces

A frequent misalignment is the so-called narrow position. “There is too little space in the mouth for the permanent teeth, either because the jaw is too small or the teeth are too large. As a result, the second teeth grow crooked and nested,” says Dr. Gundi Mindermann, chairman of the Professional Association of German Orthodontists (Berufsverband der Deutschen Kieferorthopäden). Similar things can happen if milk teeth are lost prematurely due to caries, the neighboring teeth then push into the gaps and block the space for their successors. Many children also have a bite position problem: the upper and lower jaw do not fit exactly together – usually because the upper jaw protrudes further than the lower jaw. As a result, the upper incisors are in “overbite”, i.e. clearly in front of the lower incisors. If it is the other way round, orthodontists speak of a “prebite”. And also the “open bite” – a gap between the upper and lower front teeth caused by too long pacifiers or thumb sucking – still occurs frequently despite better information.

In your favourite colour and with glitter the braces look much cooler.

The good news is that the braces often recommended by orthodontists have undergone an enormous image change – formerly known as “food grids” or “hickey brakes”, they are now considered cool. “After all, almost every second adolescent now has one. In some school classes, children without braces even belong to the minority,” says the orthodontist from Bremervörde.

Modern material and contemporary design

In addition, wearing comfort and appearance have improved considerably thanks to modern materials. “In the past, fixed braces had metal plates on their teeth without exception. Today there are various technical and optical choices – from mini brackets and discreet ceramics to coloured solutions,” says Dr. Mindermann. With removable braces, the plastic part that sits in the palate can be designed in colour or with motifs. “Colourful models are in vogue. The inconspicuous are less likely to be chosen,” the expert knows. She recommends: “Let your child have a say in the look! This makes it all the more motivated to participate in the treatment, which usually lasts between one and three years, depending on the malposition.

The right correction is available for every misalignment

Whether a fixed or loose brace is used, however, is determined solely by the problem at hand. While fixed brackets are used to adjust confused rows of teeth, removable appliances are primarily used to regulate jaw growth. “Often they are combined: First the child receives a loose clasp, later a firm one. Or we use removable, transparent plastic splints – so-called aligners,” explains Dr. Werner Schupp of the German Society for Orthodontic Aligners. Small screws (mini implants), which are inserted into the jaw within minutes under local anesthesia, are often sufficient. This prevents undesired movements of neighbouring teeth. Three-dimensional methods are also becoming increasingly important, in which the dentition situation is digitised with the aid of a scanner and the desired result is already visible before the start of treatment. In addition, 3D printing techniques today enable individual treatment apparatuses, which also reduces the number of treatment appointments.

When is it possible to get braces for children?

A favourable starting date for orthodontic treatment is the age of eight to ten years – as long as the jaw is still growing and malleable. Sometimes, however, an earlier intervention can make sense. “So that the optimal start of treatment is not missed, every child should therefore be examined by an orthodontist for the first time before starting school,” advises Schupp. A further check-up is advisable at the age of nine, in the second phase of tooth replacement.

Who pays for the braces?

Only the orthodontist can quantify the costs: Depending on the diagnosis, effort and duration of treatment, they average between 3,000 and 5,000 euros, but can also be significantly higher or lower. Statutory health insurance companies only pay for orthodontic treatment if it was started before the age of 18. And only if the medical necessity is proven by a grading system. The basis is the orthodontic indication group system (KIG) with stages 1 to 5. Only from stage 3 is the treatment paid for – which does not necessarily mean that stages 1 and 2 are purely “beauty corrections”. 80 percent of the costs are initially covered by the health insurance. The rest has to be paid by the parents themselves. If the treatment is successfully completed, he will be reimbursed. With the second child the self portion sinks to ten per cent. Extras not included In principle, the health insurance only pays what is considered adequate. You have to pay for extras (ceramics, aligners) yourself. There are big differences between the private health insurance companies. Here applies: Ask!

The right dental care for children

Is braces really necessary?

Sure is: Not every irregularity has to be corrected. The consequences of untreated tooth and jaw misalignments can, however, be considerable. This makes it more difficult to care for crooked teeth and increases the risk of tooth decay. In addition, an open bite can lead to speech defects such as lisp. And if children cannot bite and chew normally, the jaws and temporomandibular joints are incorrectly loaded. “This imbalance can cause disturbances in the descending muscles, nerves and joints – and thus headaches or back pains and even concentration problems,” says Dr. Werner Schupp. Of course, many parents wonder whether the recommended treatment is really the right one. Dr. Gundi Mindermann recommends that you seek comprehensive advice from an orthodontist and, if in doubt, obtain a second opinion. Then the treatment can be started with a good feeling. (by Michaela Roemkens / published in the familie&co Frühling 2017)

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